HIPAA: Standardized National Code Sets
HIPAA establishes standard code sets for transactions. These
standard code sets include National Drug Codes (NDCs),
International Classification of Diseases (ICD-9-CM) diagnoses
and inpatient hospital procedures, and the Health Care Finance
Administration Common Procedural Coding System (HCPCS). All
state-only and proprietary codes are disallowed for use under
the HIPAA regulations.
The Department of Health Care Services is currently reviewing their state-only and proprietary codes and will notify providers of any future changes. There are additional standardization requirements for unique identifiers and security that have not yet been finalized by the Department of Health and Human Services and may have significant impact to your organization.
Below is a list of the approved national codes.
| Codes | Standards |
| Diagnosis codes | ICD-9-CM, Volumes 1 and 2 |
| Physician services | CPT-4 (HCPCS level I) |
| Dental services | CDT-3 |
| Inpatient hospital services | ICD-9-CM, Volume 3 |
| Other health-related services | Alpha-numeric HCPCS |
| Drugs | NDC |
| Other substance, equipment and misc. health care items | Alpha-numeric HCPCS |

